Home Blog How is PCOS diagnosed?
How is PCOS diagnosed?

How is PCOS diagnosed?

There are many tests for diagnosing polycystic ovary syndrome (PCOS). PCOS can be complex to identify because there are numerous symptoms, and you don't have to have all of them to be diagnosed with it. Very few women have the same set of symptoms, and the symptoms can change at different stages of your life. The PCOS specialist will start the treatment by discussing your symptoms, undergoing medications, family medical history, and other medical conditions. Your PCOS specialist may also ask about your recent periods and weight changes. A physical examination includes checking for signs of excess hair growth, hair fall, insulin resistance, and acne.

The symptoms differ from one woman to another. Still, the three main areas they affect are reproductive and fertility and metabolic and psychological health.

Although there is no cure for PCOS, the good news is that PCOS is treatable. PCOS is more of a lifestyle disease. We know that a lifestyle can worsen or improve the symptoms of PCOS. With the help of your PCOS doctor, dietician, and fitness experts, there are many ways to manage your lifestyle and improve PCOS.

Criteria for a diagnosis of PCOS

For PCOS diagnosis, the patient should meet at least two of the following three PCOS tests:

  • Irregular periods or no periods
  • Higher levels of androgens are present in the blood (hyperandrogenism), shown by a blood test, or symptoms such as excess facial or body hair growth, hair loss, and acne.
  • Polycystic ovaries are visible on an ultrasound, which means more than 20 follicles are visible on one or both ovaries, or the size of one or both ovaries increases.

You do not need an ultrasound if you have criteria 1 and 2.

PCOS experts do not recommend ultrasound in women younger than 20 yrs. It means that irregular periods and hyperandrogenism need to be present for a diagnosis of PCOS.

Conditions similar to PCOS, like irregular periods or no periods, need to be checked to rule out any other disease before a correct diagnosis of PCOS can be confirmed.

When to see a PCOS Specialist?

If you think you might have PCOS, you need to see your gynecologist first. The signs and symptoms of PCOS can be similar to other diseases, so it is important to rule these out before a diagnosis of PCOS can be made. Not all tests are necessary for every woman – your PCOS specialists will suggest tests based on your symptoms.

Diagnosis & tests

Medical history & examination

During the PCOS diagnosis, your specialist will review your medical history and assess your physical symptoms, weight, and BMI.

PCOS blood tests

Hormonal blood tests assess the levels of androgens in your body. Blood tests for testosterone and free androgen index are the best tests for diagnosing whether you have high androgen levels. Other blood tests that can be useful in identifying high androgen levels include - sex hormone-binding globulin (SHBG), Dehydroepiandrosterone Sulfate (DHEAS), and androstenedione.

Blood tests also might be done to assess the levels of other reproductive hormones in your body, as these can also affect your periods. These can include testing levels of estrogen (the primary female sex hormone), follicle-stimulating hormone, and luteinizing hormone (LH).

Blood tests to exclude other conditions with similar symptoms to PCOS might measure the levels of Thyroid-stimulating hormone (TSH), Prolactin, and hormones related to adrenal function, e.g., 17-hydroxyprogesterone.


An ultrasound may be required to provide an image (picture) of the uterus, ovaries, and pelvis. The ultrasound photo shows any ‘cysts’ on your ovaries and whether an ovary is more significant than normal size ovaries. It is also helpful to assess the lining of the womb (endometrium), which may become thickened if periods are very irregular and is a risk factor for womb cancer.

An ultrasound is not needed if periods are irregular and there are signs or measurements of high levels of androgens. The woman is aged less than 20 years. An ultrasound is still necessary if there are very high levels of androgens or symptoms like severe hair loss, excessive hair growth, or irregular periods.

Transvaginal ultrasound

Transvaginal ultrasounds are performed on sexually active women only. It uses a pen-shaped probe with an ultrasound sensor on the tip. This probe is put inside the vagina to produce a much clearer picture than an abdominal ultrasound. It is a painless test with no radiation or side effects.

Abdominal ultrasound

The abdominal ultrasound examines the ovary from outside the stomach wall.

Other PCOS tests

Assessing your risk of developing heart disease and diabetes is significant when testing for PCOS because there are links between PCOS, insulin resistance, and being overweight. Tests to assess these risks include cholesterol blood tests, blood pressure, and glucose metabolism/tolerance blood test.

If you have PCOS, you will need a blood pressure check, cholesterol, and diabetes test every year or more frequently, depending on your condition. Suppose you have risk factors such as a family history of diabetes or previous abnormal cholesterol tests. In that case, you will need these tests more often.

Leave Comments:

Book an Appointment